Panic Attacks - Need Help In Bangkok

[unanimosity]

Lyrica & similiar

Beta blockers

Better done under the care of a specilaist, self treatment likely to go awry. Also, medication needs to be accompanied by therapy, the two work in synergy. Medication alsone is not likely to be enough.

Beta blockers are for irregular heartbeat, chest pain, and blood pressure issues so if these are not present then would not be advised. And there are potential dietary and other cautions with some beta blockers, and they can exacerbate some conditions, especially angina, heart problems, so ask your doctor if panic episodes include irregular heartbeat, chest pain, or spikes in blood pressure. In no case should one self medicate.

[Sheryl]

Lyrica & similiar

Beta blockers

Better done under the care of a specilaist, self treatment likely to go awry. Also, medication needs to be accompanied by therapy, the two work in synergy. Medication alsone is not likely to be enough.

Beta blockers are for irregular heartbeat, chest pain, and blood pressure issues so if these are not present then would not be advised. And there are potential dietary and other cautions with some beta blockers, and they can exacerbate some conditions, especially angina, heart problems, so ask your doctor if panic episodes include irregular heartbeat, chest pain, or spikes in blood pressure. In no case should one self medicate.

They are used for that, yes, but they are also used in management of anxiety disorders. Agree that should not self-treat for this condition.

[unanimosity]

Your friend will do no harm and may find comfort in having a full allergy panel done to eliminate any kind of environmental factors at play.

Your friend will also do no harm and may find relief through clinical hypnosis.

Edited July 15, 2013 by unanimosity

[metrox]

I had panic attacks almost daily for 5 years until I found the solution that worked for me:

1st. Be sure there is no preexisting condition such as anxiolytic medication abuse, alcoholic or drug addiction. If your friend suffer of any dependance he have to do a detox first. Stop smoking, drinking alcohol, coffee, tea, cola, or any caffeine drinks, sleep at least 8 hours, eat breakfast early in the morning, do exercise.

2nd. Move to a quiet area, because noise, crowded and busy areas, public transportation and lack of horizon doesn't help.

3rd. Once the symptoms are less difficult to deal with, start to work out on the psychological causes, it is often come from frustrations or trauma around 7 to 15 years old.

4th. I insist on the fact that anxiolytics doesn't help on the medium and the long term, it's only short term aid but the next attack will be worst.

5th. Tell your friend to give himself some time, it's took me 3 to 6 month to feel the benefits of this method, at the beginning it was really hard. But now I have a normal life again, I am OK from 7 years now, It could happen to me some small attack but nothing that I can not handle and at a very low frequency, every two to three month, and I relax 30 min and it's ok.

Feel free to PM me for more informations.

Hop you friend will recover fast.

[Bard]

Just want to come with some input to this one, as I have PTSD and I am very used to panic attacks so it might bear some value for your friend.

First of all he needs to know first aid, namely what to do when an attack comes. He needs to understand a panic attack is not deadly, nor harmful to his body, by knowing this he will not fear for his life when it happens. The best first aid he can do is the following. Concentrate about your breath, take deep breaths and hold your breath while counting to ten, then release. Hold a hand on top of your stomach and assure you are breathing with your stomach. Then he will experience the attack dampens and goes away quicker.

Secondly he needs therapy, by figuring out what triggers the attacks the therapist can use for example cognitive therapy to help and that in the long run will make it so much easier to live with. He will then understand what triggers it, and how to work it through, plus should it plummet out of control he knows first aid to dampen and remove it. If this is anxiety, PTSD or what have we most of it he can learn to live with without any medications in the long run. If it is an underlying disorder well then the right medications will let him live with that.

Thirdly he needs to understand that this is not uncommon, it is estimated that 1/3 of all adults will experience this is a more or less way. He also has to understand it is nothing to be ashamed over; it is silly to sit on it of the simple reason. If you sit on it and don’t want anyone to know you are scared to experience it, then believe me this will trigger more panic attacks as he is scared of “losing it” which is the most common reason for panic attacks. By just telling people around he can dampen a lot of it.

Lastly the one most definitely worst thing he can do is to drink alcohol as that worsens every underlying trigger. To self-medicate with alcohol, or just popping pills is not removing the problem, it is pushing it in front with an exponential development. I’ve been there so I know this really well. Anyone wonders why there are so many suicides amongst foreigners living in Thailand?

I cannot help telling you about where and who can help in Bangkok though, I gave up on it in Thailand and got better in Europe and is now so well I can live a great life again.

[watgate]

I worked with a fellow, my former supervisor, who got panic attacks. He sought out help and went to a psychiatrist who prescribed specific meds which greatly relieved his attacks to the point where he was a very efficient and personable individual who could perform his assigned tasks at work. He always said that counseling and cognitive therapy was very costly and would undoubtedly take a long time with the distinct possibility of not much realistic help for his panic attacks so he opted for meds to control and relieve his attacks. There are definitely very beneficial meds out there so your friend should explore them and hopefullly find one or more that will help him with his attacks.

Edited July 15, 2013 by watgate

[DGIE]

Can anybody narate how this panic attack is when it attacks?

What does the patient do when he is attacked by panic attack?

[Sheryl]

There is a special therapeutic technique called Eye Movement Rapid Desensitization (EMRD) which is very effective for PTSD and related problems. requires a therapist specially trained in it. This site can provide lists by geographical area. http://www.emdr.com/

I've had this type of therapy myself and the results are very impressive.

[realenglish1]

I had panic attacks too They where vary bad and at times I felt Like I wanted to commit suicide. But guess what I was addicted to Valium and had to slowly taper off the drug to get a normal life. I have been valuim free for a long time now and all the panic attacks are gone

Diazapam is bad and can cause the same symptoms you friend is having so if he is taking Valium now get him off of it And if he is prescribed them make sure he does not take them

They are really bad for you

[Polkadotskies69]

Hi there, haven't read all the posts so don't know if someone has already said....

But there is a British therapist I know of in Bangkok...I'll post again later with the details as haven't got them with me right now...she is connected to med consult clinic on sukhumvit 49/9 at the racquet club....I'll post again later when I get home

[SouthernMan3]

I can help with this but am not willing to post about it on this board.

You may contact me via private message and we can go from there.

I feel for your friend.

I've been there.

[cobra1]

He can't share this with others but he's a very good friend of mine and only I know about it. and everybody looking on Thai visa as well now !!!(GET HIM SOME XANEX) he be well chilled from his panic attacks1 a day avoid alcohol unless he's a hardened alcholic then he ok

[pest]

coffee,redbull,alcohol all trigger my bouts

just stay off them for a while and see

[cobra1]

He can't share this with others but he's a very good friend of mine and only I know about it. and everybody looking on Thai visa as well now !!!(GET HIM SOME XANEX) he be well chilled from his panic attacks1 a day avoid alcohol unless he's a hardened alcholic then he ok

sorry guys i really do feel 4 you all!!!!!!!!!!!!!! but did not think Thai visa as the name suggests is a on line health forum clinic love all the Thai related post /visa issues/and all other Thailand related posts and most of all the humour of all you guys to replys /topics but This dont belong here and yes i have been there my strong mind sorted my self out

[1FinickyOne]

Just skimming down this, what you can learn is that, if nothing else, everyone is different and different things work for different people and from my observations, at different times as the pos effects of the meds can wear out.

It is a terrible thing and truth is they don't really have a handle on this yet - again, as evidenced above.

My mom suffered terribly for many many years and then a doc put her on zoloft. It took a little while to kick in, and then it almost worked too well. She was so well that she became incredibly extroverted and near out of control, talking to everyone and anyone, and not stopping sometimes. But, it was nice to see her happy. I think that lasted abt 3-4 yrs. - - so, as to the meds, there might be osme trial and error to see what works.

I have had many friends go through this - some try psychiatry and it is dificullt to see if there was some help there, there is no control group on that to measure what the person might have been like w/o it. But, I have never seen it work too well. I do have other friends who are exp. a longer term stability w/meds at the price of erectile dysfunction. So, this is not easy ground... good luck - research and experiment and observe.

[have 3 close friends who commited suicide]

[asupeartea]

Panic attacks can be undiagnosed other things like allergies. A friend had them, found out she was allergic to some of the foods she ate, stopped eating them and got over them.

Just as well could be too much caffeine or something else.

Edited July 15, 2013 by asupeartea

[ableguy]

Panic attacks can be the warning of very serious problems, my brother had them and it later turned out he had lou gherics disease or crone syndromem get help from a competant hospital,

[alfalfa19]

I agree with what a couple of other posters have written. Avoid benzos (valium, xanax, rohypnol, and a dozen others) like the plague. What comes up must come down. And with benzos, the comedown is very hard. It takes a long time to get addicted to them, but once you are, getting off is a very long term and horrifying process. It makes heroin addiction look pleasant. I tend to suffer from panic attacks also. I've learned to be much more cognizant of my mental state, and when I feel any sign of them approaching ( rapid heartbeat, vertigo, lightheadedness, rapid and shallow breathing, etc.) I carefully breathe deeply and slowly, and get a grip on myself. One's affinity with their own breathing patterns is the best tool for this. Drugs are a very temporary solution, and they can lead to much greater horrors.

[gregk0543]

Maybe vitamin B12 deficiency

[Sheryl]

He can't share this with others but he's a very good friend of mine and only I know about it. and everybody looking on Thai visa as well now !!!(GET HIM SOME XANEX) he be well chilled from his panic attacks1 a day avoid alcohol unless he's a hardened alcholic then he ok

Under NO circumstances should this advice be heeded.

As other posts have mentioned, benzos are a dangerous option for this problem and should be avoided if at all possible; in fact benzo withdrawal is a not infrequent cause of the problem.

No-one should self-medicate (nor medicate a friend) for panic disorder. You risk making a bad problem vastly worse. (You also may be breaking the law, as benzos are controlled drugs and illegal to purchase except from a hospital pharmacy on prescription). Get professional treatment. Elsewhere in this thread some specific doctors and therapist have been recommended.

[Seeker1953]

Your friend needs both medication from a psychiatrist and counseling from a therapist. There is a pinned thread here with resources for counseling. http://www.thaivisa.com/forum/topic/90910-mental-health-resource-list/ I would suggest trying Ben Wienstein at PSI first. For doctor, if your friend's condition is not urgent then I would get into therapy first and let the therapist refer, as all psychologists have psychiatrists they work with for patients needing medication. If it cannot wait for that, this doctor at Bumrungrad specializes in panic disorders: http://www.bumrungrad.com/doctors/Spain-Uneanong

I also recommend you or your friend contact PSI here in Bangkok. Dr Ben Wienstein is a gifted man and if he cannot help your friend himself, I'm confident he'll direct you to someone who can.

Respectfully,

Seeker

[Sheryl]

Yes, there are many good resources in Thailand. Both for medical management and short-term therapy.

While B12 deficiency can create neurological symptoms, not a full fledged panic disorder.

[wcoast]

I'm totally anti drug. As others have suggested recognizing the root issue is key. That said traditional Thai massage is a fantastic way to calm yourself, ease tension,s and relax the body. The human tactile interaction is very therapeutic Find a nice quiet shop with a soothing atmosphere and a calm humble practioner, book for a couple Hrs a few times a week.

I would recommend this in addition to a psycho therapeutic evaluation of course.

Good luck and thanks for being a caring friend.

[ChrisB87]

Some peope may find this silly, but Vipassana Meditation could help (they claim that certain mental disorders are eradicated eventually with this technique, although that isn't the actually purspose of practicing)

Here is a link. (you book through this website - there are about 5 centers in Thailand) http://www.dhamma.org/

Its totally free - you get your bed, food, and meditaion for 10 days. (they accept donations of course)

I have heard Kanchanaburi is the most comfortable (it's the newest), but i haven't been to that one. Prachinburi and Khon Kaen are quite old and basic, not that that really matters much when considering what you are there to do.

Edited July 15, 2013 by ChrisB87

[Sheryl]

Vipassana is definitely helpful in resolving anxiety and the like but a person experiencing frequent panic attacks may not be stable enough to undergo it. In some cases the technique may trigger an attack, as it is a very deep technique that opens up the unconscious mind. Usually with someone with this sort of problem they will require a letter from a doctor or therapist describing the condition and stating that the patient can safely undergo an intensive course of meditation.

I would suggest getting the attacks under control first, and then indeed, a Vipassana course if acceptable to you would be a good idea. It is not necessary to be a Buddhist or held any particular belief to undertake it and benefit from it.

[manarak]

I see OP hasn't posted back for a long time, but here are my 2 cents anyway:

In my life I had two to three panic attacks when I was contemplating a job in Tokyo.

I was unemployed at the time, and really felt a lot of pressure on my shoulders to find a job again.

While every cell in my body was screaming against taking the job in Tokyo, I tried to rationalize and make my mind to take it.

When I literally forced myself to accept the situation, the panic attacks occured. horrible.

Refused the job and never had panic attacks again.

I will never work in Tokyo.

Might be ok with lots of cash though.

So... my advice to OP: find out the reason for feeling overwhelmed and powerless and eliminate it.

Edited July 15, 2013 by manarak

[BanTamo]

Citalopram, buproprion, lamotragene, lorazepam, and all the non-pharmacological measures above will help a lot. But do your friend a favor and make sure he's monitored by a psychiatrist with specialist training. Difficult but not impossible to come by in Thailand. Not too difficult in Bangkok.

Good luck to you both.

[Bard]

Can anybody narate how this panic attack is when it attacks?

What does the patient do when he is attacked by panic attack?

I will try to explain from my own experiences. I get fake heart attacks. I get tingling in my fingers, dizzy, chest pain right where my heart is and nausea. Before I learned how to deal with it, I believed I had a heart attack and that I was dying. That is how my attacks appeared, extremely crap when you have this in a meeting for instance and everyone calls ambulance and full on emergency. Then later find out it was nothing, and even later you find out it was created by your mind.

I read many write benzos is of help, they do there and then but they worsen the root cause, and the quacks in Thailand just pour on more benzos and the like until you have to have them to function. Believe me your situation will worsen more and more and you might get serious psychological problems. Benzos are first aid, and any prolonged usage is very bad for you. You might not feel it now, but enough psychological (real) experts can explain you how dangerous this is.

[Sheryl]

It is not unusual for panic attacks to end up in an emergency room as a suspected heart attack and while medical personnel can quickly rule out heart attack through tests, they cannot do so just by the appearance of the patient and the symptoms- these can be indistinguishable. That's how severe a true panic attack can be. It should not be confused with simple anxiety.

[jrtmedic]

Anxiety can manifest in one's mood, behaviour, thoughts, and emotions. Symptoms of anxiety can be mild to severe. Mild symptoms include a slight elevation in heart rate and increased alertness. More severe symptoms can include severe feelings of panic, palpitations, chest pain, and shortness of breath.

These issues are are easily diagnosed in an Emergency Room but as Sheryl says not by pure observation.

Anxiety/Panic attacks are best addressed by Cognitive Therapy. The use of medication , other than on a very short term basis, is almost always a very bad idea.